While the world races to contain the spread of COVID-19, a team of researchers at York University has been tagged by the World Health Organization to lead a global effort against another deadly pandemic.

The Global Strategy Lab at York is the new WHO Collaborating Centre on Global Governance of Antimicrobial Resistance (WHOCC), the only such centre focused on the issue globally. It is tasked with providing with technical guidance, policy analysis and international legal advice on what kind of international commitments and frameworks are needed to tackle antimicrobial resistance—a problem that the WHO has identified as one of the top 10 global threats to public health.

“When it comes to antimicrobial resistance, this isn’t something Canada can do alone,” says Dr. Steven Hoffman, director of the Global Strategy Lab and the Dahdaleh Distinguished Chair in Global Governance and Legal Epidemiology at York. “International cooperation is essential because viruses and bacteria don’t carry passports. They transcend national borders, which means even if we do everything right in Canada, all it takes is for one resistant microbe to travel on an airplane and travel to Canada for us to be faced with the exact same problem.”

The overuse of medicines in humans, livestock and agriculture as well as poor access to clean water, sanitation and hygiene have accelerated the AMR threat worldwide, which the WHO has warned makes common infections harder to treat and accelerates the risk of the spread of disease, severe illness and death.

AMR has been described as a silent pandemic. Drug-resistant infections often move unnoticed within populations and between animals, humans and environments. Drug-resistant superbugs kill an estimated 700,000 people annually, and without action, the WHO warns this could climb to 10 million deaths per year by 2050, “which is more than the number of people who currently die of cancer,” says Hoffman.

The York lab had already developed an international reputation for advising the world's governments and public health organizations, including the WHO, on how to design laws, policies and institutions that address transnational health threats, including thorny issues such as tobacco control and health misinformation. As part of the WHOCC, its 26-member research team will work with colleagues from around the world from disciplines as diverse as law, epidemiology, political science, communications and ethics.

AMR is a “collection action problem”

Antimicrobial resistance, like COVID-19 and climate change, requires international cooperation and commitments, but politics, economic considerations and public attitudes can hinder these efforts. Involving the social sciences, says Hoffman, makes it possible to develop solutions that not only work in theory, but also in practice.

“We’re building a science about how countries can work together to address this global health threat,” he says. This includes designing international institutional arrangements that “not only solve the problem but are also politically feasible, legally acceptable and continually incentivize compliance with the measures that are involved.”

Current international laws and treaties to protect the environment, for example, compel countries to take coordinated action. “That approach holds a lot of promise for antimicrobial resistance given it is a very similar collective action problem,” he adds.

Such agreements could pave the way for implementing national AMR action plans, including surveillance systems that track how microbes are evolving or commit countries to funding the development of new antibiotics.

“If there’s a silver living from COVID-19, it might be the way it has brought attention and political will to addressing these kinds of infectious disease threats that transcend national boundaries,” says Hoffman. “The current pandemic gives us a window into a future that we really don’t want if we allow antimicrobial resistance to continue unabated.”

WHOCC’s work includes:

• Conducting comparative analyses of political mobilization and accountability mechanisms that could be helpful in promoting global collective action on AMR;
• Providing advice on political mobilization and accountability mechanisms that WHO and its Member States can use to support global and country-level action on AMR;
• Analyzing the incentives needed to encourage countries to better steward antimicrobials and the political economy problems underlying inaction on AMR and;
• Providing ongoing advice on various proposed global governance frameworks, mechanisms, laws and regulations that aim to address antimicrobial resistance.

The WHO’s initial announcement of the new Collaborating Centre was made over a year ago, but the official launch was delayed until recently as a result of the COVID-19 pandemic.

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